Make sure if your laboratory can measure the drug or drugs that you expect this person might be using, and whether blood or urine tests are better according to the particular drug and time since ingestion, if you are asking for a drug screen to understand if the client has recently used an illicit drug.
LSD is used in much smaller amounts and may not be detectable even if recently used, most labs can test for cocaine presence. Such a call requires that you step out of your typical ‘nonmedical’ role and interact with a strange and often forbidding medical system, this kind of question can be answered by a call to the local chemistry lab hospital.
We are able to carry out our vital work thanks to financial support from those like you -people who realize our importance continuous public education regarding alternative mental health choices.
Your donation to Safe Harbor could make THE difference in another person’s life. Whenever working in academic centers and aware of organic possibility illness, miss medical illnesses with disturbing frequency, even internists and neurologists. That a medical illness is missed, the patient’s symptoms seem different than those described in the medical textbooks. Just think for a moment. Some illnesses are hard to diagnose, especially at the beginning. The specific tests that would allow the diagnosis are not considered because Others are so rare that they are not thought. Now pay attention please. There is no set of tests that can definitively rule everything out. Still other times the illnesses present atypically.
Telling the client to see his local doctor, or phoning the local internist with a request to Please do a physical exam on this client.
Could you see if any thyroid problems or any other medical problems might be increasing his depression? He was treated for hyperthyroidism 15 years ago. He is also complaining of increased weight, cold intolerance, decreased libido and extremely dry skin, even better yet, This patient is complaining of depression with decreased energy level. Another question is. Could you please see if there may be a medical illness involved? This client has a depression that seems very atypical.
9 times out of 10 you shall not be able to frame a consult request with as much detail as this last example but in all cases the more the better. It often presents initially with nonspecific symptoms such as fatigue, malaise, anorexia and weight loss, all of which can lead to functional diagnosis depression. Rather than any particular symptom suggesting a particular illness, the referral to the physician is based on a pattern suggesting a higher probability of medical illness. The physician needs to have that information, if this is the reason you are referring the client. Any client who initially develops psychiatric symptoms over 40 age should have a medical workup. Systemic lupus erythematosus is most often seen in women ‘1340’ years old.
Conservative estimates suggest that 10percent of persons initially seen in outpatient settings for psychological symptoms have an organic disease causing the symptoms.
The second problem is that it is almost impossible to talk about medical illnesses without lapsing into medical jargon. This figure is higher in the elderly, in persons with certain diagnosis such as hysteria, and much higher in inpatient settings. I’m sure it sounds familiar.|Doesn’t it sound familiar?|Sounds familiar?|right? This is half a paper about medical illnesses, and half a paper on learning a brand new language that will hopefully help you when you should communicate to other physicians.
Important information is likely to get lost, if the client is less than articulate. The patient with panic attacks may have a pheochromocytoma, a tumor that secretes epinephrine. It is also a problem when the symptoms you want evaluated are vague, or your concerns leading to the referral do not relate to a particular medical symptom. The depressed patient may have an under active thyroid gland. Basically, every time a patient comes into your office, your emergency room or your hospital, there is a very real possibility that what seems to be a psychological problem is caused by some physical illness. The patient, whose personality change and increased irritability is thought to be caused by his marital problems, may actually have a brain tumor causing the personality changes and exacerbating longstanding marital issues. Your job must include organizing the information that you have collected and transmitting it to the doctor in such a way as to do your client the most good. This is a particular problem with older clients, those who are hard of hearing or who have other communication problems, or those who are less organized or less clear in their thinking.
Information Much that you have to suspect a medical illness is readily available as part of a psychiatric assessment.
It is useful since It is important to know how to organize this information, and to fill in gaps in your information so that important areas are not missed. The goal ain’t to come up with a specific diagnosis. You can decide what to do next, The goal is to organize the data that you collect about the patient, how worried you ought to be, and when and how and what to say to your consulting physician if you decide further medical assessment is necessary.
Having said all of that, I will try to organize illnesses by their psychological effects,, at the same time, try to introduce the way that physicians would organize their thinking about those illnesses. The first is that there are a huge number of different possible illnesses to worry about.
Physicians organize the world much differently. The easiest way to remember separate all facts and to see patterns is to organize illnesses in accordance with physiological systems. It does not do much good to think about illnesses list that can present as depression unless you begin to think about plenty of the other associated symptoms that those illnesses also haveand better way to organize these associated symptoms is to understand what organ systems the illness effects. It ain’t always so obvious for quite a bit of the world, for someone who has been through medical school, this becomes the obvious way to organize things. The problem with categorizing in consonance with psychiatric symptoms will become obvious as you go through this paper. Throughout this paper I will talk about endocrine systems, neurological systems and cardiopulmonary systems.
Also so that you can understand the person’s current feelings and functioning within what context has happened to the person in the past and what is happening now, this is )needed required in order to rule out a medical illness.
Medical causes of psychiatric symptoms should always be considered. All of the time our medical workups are unnecessarybut all of the time isn’t nearly identical to generally. Usually, how common is this problem? That said, very…and not very. Notice that virtually, amongst the problems is that most really serious medical illnesses are rare enough that we all get sloppy and stop looking for them. With all that said. You should know enough about these medical illnesses to make some basic assessment about whether a further medical assessment is necessary and how to focus that assessment as to make it as productive as possible, as a mental health professional. Dozens of your clients won’t have a medical disease masquerading as an emotional problem. It isn’t necessary to live in abject terror about missing patients all with unsuspected medical illnesses that come to you with symptoms of depression or anxiety.
The third problem is both more subtle and more serious.
The problem is that the depression caused by a brain tumor can be identical to the depression caused by marital discord or by an endogenous depression. Many illnesses can cause many different psychological symptoms. Such a listing would not help to understand what other questions to ask to help separate physical from psychological illnesses. What is likely to be different is the patient’s history and the associated signs and symptoms apart from the depression. Keep reading! The question is, what medical illnesses can cause depression, anxiety, etc? Now look. Listing illnesses in consonance with which ones can cause depression or which ones can cause anxiety does not produce a coherent organization. Just think for a moment. Non medical’ mental health professionals organize the world conforming to psychological symptoms.
Physicians tend to dismiss psychiatric patients for several reasons. Editor’s note. Anyway, at times these patients behave in ways that make evaluation more difficult, either by being unwilling to give a full history, unable to give an accurate description of symptoms, or o frightened to allow a full physical examination. Physicians are often uncomfortable around patients who are obviously depressed or who are acting bizarrely, or who they are afraid might act bizarrely. We are grateful to Dr. There is a tendency to assume that all psych patients are just nuts without real illness. Notice, lastly, many clinicians believe that patients may suffer from medical conditions, such as hypothyroidism, that can be missed by standard medical lab tests, therefore, be overlooked on studies applying standard medical screening. When extensive testing is done, it should also be noted that some studies have shown that medical causes may account for substantially more than 10% of patients with mental symptoms. The reader should note that this article only covers standard medical causes of mental symptoms and does not include many other physical causes, such as nutritional imbalances and metabolic abnormalities, listed in other articles on AlternativeMentalHealth. Of course, the following is the finest article we have found on medical subject causes of severe mental symptoms. Diamond for his permission to reprint.
There are differences of communication styles between mental health professionals and physicians. With a clinic full of patients waiting to be seen, the physician is likely to be in office middle hours. The social worker or psychologist is likely to want to give the physician a complete patient description and the significant problem in a phone discussion that may go on for many minutes.
Studies have demonstrated that disliked patients are more likely to have an undiagnosed organic brain syndrome than more likable patients, and it is just those disliked patients that will often get the most cursory and incomplete physical evaluation.
Even in patients who clearly have schizophrenia or some other diagnosable mental illness and who have had an excellent medical workup in the past, it is important to consider whether their current complaints or recent change in behavior could’ve been related to a medical illness. Anyway, one should always be concerned that a medical illness might, as a matter of fact, be the psychosis cause. My guess is that patients who are most different from their physicians are also more likely to have a medical illness missed, and this is especially true of psychiatric patients. Of course, as a matter of fact, psychotic patients are more difficult to evaluate, and if they do happen to have a serious medical illness, it is more likely to get missed. The fact that someone is actively psychotic does not mean that they do not also have a serious medical illness.
The reader should note that this article only covers standard medical causes of mental symptoms and does not include many other physical causes, such as nutritional imbalances and metabolic abnormalities, listed in other articles on AlternativeMentalHealth.
When extensive testing is done, it should also be noted that some studies have shown that medical causes may account for substantially more than 10% of patients with mental symptoms. Lastly, many clinicians believe that patients may suffer from medical conditions, such as hypothyroidism, that can be missed by standard medical lab tests, therefore, be overlooked on studies applying standard medical screening.