Psychological medical examination is a series of examinations to determine whether a person suffers from mental problems or not. Sseries of checks the include interview, physical examination,and test written through a questionnaire. Inspection psychiatric medical usually performed by a specialist psychiatry(psychiatrist) or psychologist.
Psychiatric problems or mental health disorders are often associated with certain psychological factors, such as prolonged stress. But actually, there are several factors that can affect the emergence of mental disorders, namely:
- Have a family history of psychiatric disorders (genetic).
- Certain physical disorders such as cancer or damage to organs, such as the brain.
- Side effects of drugs and alcohol.
- The environment around the patient, including social and cultural factors.
Psychiatric problems that occur can appear in various forms, such as changes in mood or mood such as depression and irritability, personality disorders, sleep disorders, anxiety disorders, behavioral disorders, hallucinations, to psychosis.
If the symptoms of the mental disorder have interfered with daily activities, the patient is advised to have his condition checked, so that treatment can be taken immediately.
Psychological medical examination can be carried out as a routine or emergency examination if the patient's mental condition requires emergency treatment. Routine psychiatric examination will examine the patient's mental condition thoroughly and in detail. Meanwhile, the emergency psychiatric examination focuses more on the symptoms, history of disorders, and the behavior of the patient before the emergence of a psychiatric disorder.
Keep in mind that psychiatric medical examinations are often time-consuming, and each patient will need a different amount of time from the examination process to the completion of a psychiatric diagnosis. Neither the patient nor the patient's family should request an expedited psychiatric examination, so that the results of the diagnosis obtained are accurate.
Indications for Psychiatric Medical Examination
Psychiatric medical examination aims to detect mental and behavioral disorders in a person. This is done because not all psychiatric disorders can be detected easily. In fact, sometimes someone who experiences mental problems does not show any symptoms at all or is difficult to distinguish from normal people's behavior. One of the characteristics that indicate a person suffering from mental illness is psychological symptoms that occur continuously.
For example, when someone experiences grief when a family or close person dies, it is natural to feel sad and grieving. However, if this feeling of sadness persists for a long time or is felt severe enough to cause certain complaints such as suicidal ideation, sleeplessness, and difficulty carrying out daily activities, it can be said that a person has shown signs and symptoms of a mental disorder.
In addition to the examples above, psychological medical examinations can also be carried out for other reasons, namely when requested by the authorities or the court to conduct a mental examination of a suspected criminal. This psychiatric examination is to assist the legal process in ascertaining whether the person is mentally fit to undergo trial.
Psychiatric Medical Examination Warning
There are no special warnings or contraindications that prevent patients from undergoing psychiatric medical examinations. If the patient agrees to undergo a psychiatric examination and gives informed consent (informed consent) for examination, the doctor can start the examination. However, if the patient is deemed to be a danger to himself or the examiner, his family and staff can take security measures to maintain safety during the examination.
As long as the patient's and staff's personal safety cannot be maintained due to the patient's behavior, a psychiatric medical examination is highly recommended to be carried out in a hospital. During the examination, the patient needs to tell the problems they are facing and answer the doctor's questions honestly. This is important to assist doctors in determining the diagnosis and appropriate treatment steps.
Psychiatric Medical Examination Preparation
There is no special preparation that needs to be done before undergoing a psychiatric medical examination. If necessary, the doctor or psychologist will also interview the patient's family so that the results of the examination carried out are more accurate. The patient's family will also be asked for their considerations in choosing the treatment that the patient will undergo after the results of the psychiatric examination are known. Consideration of the patient's family or guardian is necessary, if the patient is unable (incompetent) to consider the benefits and risks of the treatment that will be given after the examination is complete.
Before undergoing the examination, it is also a good idea for the patient or family to record complaints and a history of the problems encountered, such as when the symptoms started, what triggers or aggravates the symptoms being complained of, and what emotions the patient has been feeling so far.
Psychiatric Medical Examination Procedures
Doctors and psychologists will conduct psychiatric medical examinations of patients through various methods. However, the most important methods used in psychiatric medical examinations are interviews and observations, either with the patient or with the patient's family. However, other additional tests such as blood or urine tests may also be done to support or confirm the diagnosis.
Psychiatric Medical Examination Through Interview
When undergoing a psychiatric medical examination, the patient will be asked for information about his history and general condition by a psychiatrist during an interview. If the patient cannot provide information, then an interview can be conducted with the patient's family or closest person. Information that a psychiatrist may request from patients and their families includes:
- Patient identity, the aim is to find out the patient's personal data and also for the psychiatrist's personal approach to the patient. Data that will be requested includes name, occupation, marital status, educational history, and other matters regarding the patient's social and cultural background.
- The main purpose of the patient undergoing a psychiatric medical examination. The aim is to identify the main reasons the patient undergoes a psychiatric medical examination. This identification is often done in the form of general questions by the psychiatrist who provokes the patient to tell in detail his complaint to the psychiatrist.
- Examination of mental illness that is being suffered. This is the most important examination to determine the diagnosis of a mental disorder that is being suffered. The psychiatrist will ask the patient or family to describe the symptoms and history of mental disorders in as much detail as possible. In addition to mental symptoms, doctors also need to assess whether there are physical symptoms that the patient feels.
- Examination of the patient's medical history. The psychiatrist will ask about the diseases that the patient has or is currently suffering from. The psychiatrist can also ask about the history of the patient's medical procedures, especially the history of surgery.
- Drug and allergy testing. To complete the information on the patient's health condition, it is also necessary to know the drugs consumed and the allergies suffered by the patient.
- History mental disorders in the family.If there is a close family member who has suffered from mental disorders or psychiatric problems, the patient or family should share this information with a psychiatrist.
- Environmental and social history of the patient. This examination includes collecting information regarding the patient's social condition, including educational history, work environment, number of children, and the patient's criminal history. The patient's habits must also be informed, especially habits that can damage the patient's physical and mental health, such as smoking, drinking alcohol, or taking drugs.
- Patient development history. This information is important if the patient has had complications at birth or was born prematurely.
Apart from the interview, the psychiatrist will also conduct a psychiatric medical examination by making careful and thorough observations to evaluate the mental condition of the patient.
Mental Status Observation
Examination of the patient's mental condition through observation of mental status starts from observing the patient's personal condition at the beginning of the interview. The things that were observed in this inspection, among others:
- Patient appearance. The psychiatrist will make observations starting from the moment the patient enters the examination room. Things that are evaluated in this observation such as whether the patient is relaxed or agitated, body posture, gait, and clothing of the patient. The doctor will assess whether the patient's clothing and general appearance are appropriate for the patient's situation, age, and gender.
- Attitude of the patient to the psychiatrist. Such as facial expressions during the examination, the patient's eye contact with the psychiatrist, whether the patient looks at a certain point such as the ceiling or floor during the examination, and whether the patient is willing to be invited to cooperate during the examination (cooperative) or not.
- Mood and affect patient. Especially the mood of the patient's feelings and emotions everyday. Does the patient feel sad, anxious, angry, or happy during a normal day? The patient's affect can be seen from the behavior and facial expressions that the patient expresses during the examination. Conformity to the mood can be seen from whether when claiming to be happy, the patient looks smiling, gloomy, or shows no expression at all.
- Speech pattern. Speech patterns can be seen from the patient's voice volume and intonation during the interview, the quality and quantity of speech, the speed of speech, and how the patient responds to interview questions, whether the patient only answers simply or tells a long story.
- Thinking process. The patient's thought process can be evaluated from how the patient tells stories during the interview. The things that will be examined from the patient's thought process are the relationship between speech, whether the patient often changes the topic of conversation, or whether the patient speaks in unusual and incomprehensible words. The patient's perception and responsiveness to reality or whether the patient has hallucinations or delusions will also be examined.
- Content or thought content. Examination of the content of the patient's mind can be seen from:
- Patient orientation, especially whether the patient knows who he is, knows when and where he is.
- Patient awareness.
- The patient's ability to write, read and remember.
- The ability to think abstractly, such as the similarities and differences between two objects.
- General knowledge and intelligence of the patient at the time of the interview.
- Willingness to kill.
- Suicide desire.
- phobia.
- Obsession, especially in patients with obsessive compulsive disorder (OCD).
- self-understanding (insight). The doctor will evaluate whether the patient understands the severity or is aware of the mental disorder he is suffering from. The patient's attitude towards the mental disorder he is suffering from will also be examined, including his attitude towards health workers who are trying to deal with the mental problem.
- Consideration (judgment). Patients will be examined for their ability to weigh a case and make decisions based on these considerations. Generally, psychiatrists will assess the patient's assessment function by making a scenario in the form of a story, which will involve the patient to make a decision in the scenario.
- Impulsivity.The patient will be examined regarding his impulsivity and ability to control his impulsivity. The psychiatrist will also assess whether the patient can withstand the urge (impulse) through the interview.
- Reliability (reliability). The psychiatrist or psychologist will assess whether the patient can be trusted or relied on, based on information that has been obtained from observations and interviews that have been undertaken.
Supporting Examination and Psychotest
If necessary, the patient will be asked to undergo additional examinations to help the psychiatrist make a diagnosis. These investigations can be in the form of blood and urine examinations in the laboratory or with imaging, such as CT scan and brain MRI.
In addition to undergoing a psychiatric medical examination through interviews and observations with a psychiatrist, patients may also be asked to undergo further examinations, namely psychological tests. This examination is intended to more deeply evaluate mental function and specific matters related to the patient's psyche, such as personality type, level of intelligence (IQ), and emotional intelligence (EQ) of the patient.
Psychological tests are generally carried out in the form of filling out questionnaires or sheets containing certain questions or instructions. Patients will generally be asked to fill out this questionnaire within a certain time and read or receive certain directions from a psychiatrist before starting the psychological test. When undergoing psychological tests, patients are encouraged to fill out honestly, this is important so that the psychiatrist can evaluate and diagnose the patient's condition correctly.
After Psychiatric Medical Examination
Patient data taken and collected during a psychiatric medical examination will be analyzed by a psychiatrist to determine the problems and mental disorders suffered by the patient. Through this analysis, the psychiatrist can determine the mental disorder suffered by the patient accurately and then plan the treatment steps that will be taken by the patient.
The type of treatment the patient will undergo depends on the severity of the disorder. Generally, the treatment of mental disorders or psychiatric problems that are experienced will be carried out by a team that involves a psychiatrist, family, doctor, psychologist, and nurse. For patients who do not have families, other related parties such as social workers or officers from social services will also be involved.
Methods of treating mental disorders or psychiatric problems that can be undertaken by patients include:
- Psychotherapy.Psychotherapy is treatment for psychiatric problems by talking, or through counseling guidance with a psychiatrist or psychologist. Psychotherapy is generally done for several months, but in some cases, it can be done in the long term.
- Administration of drugs. Giving drugs can not cure mental disorders suffered by patients. However, it can relieve symptoms of mental disorders and can help other methods of therapy work more effectively. The administration of drugs to treat mental disorders must be under the supervision of a psychiatrist. It should be noted that psychologists cannot prescribe drugs. Some types of drugs that are usually used to treat mental disorders are:
- Antidepressants.
- Antipsychotics.
- Stabilizer mood (mood stabilizer).
- Anxiety medication.
- Sedative.
- Brain stimulation. Brain stimulation is done by stimulating the brain using electricity and magnetism to treat mental health disorders. This method may be used if psychotherapy and medication do not provide effective results.
