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How Physicians Screen for Psychosis

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Shenandoah Valley Family Practice Residency prepares doctors for careers in a broad range of health care settings. To ensure participants' competency in places with fewer resources, such as rural practices, Shenandoah Valley Family Practice Residency provides more training in emergency psychiatry in comparison to other programs.

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How Physicians Screen for Psychosis

  1. 1. HOW PHYSICIANS SCREEN FOR PSYCHOSIS Shenandoah Valley Family Practice Residency
  2. 2. INTRODUCTION  Shenandoah Valley Family Practice Residency prepares doctors for careers in a broad range of health care settings. To ensure participants' competency in places with fewer resources, such as rural practices, Shenandoah Valley Family Practice Residency provides more training in emergency psychiatry in comparison to other programs. Any physician with emergency psychiatry responsibilities must know how to assess for psychosis. This primarily involves screening for reality disturbances, which are present in all psychotic cases. The physician needs to evaluate whether the patient is subject to visual or auditory hallucinations as well as false or irrational beliefs, known as delusions. The physician assessing for psychosis will also evaluate whether the patient's rational thinking capacity is impaired. The patient may be confused, and thoughts may be disorganized or illogical. In some cases, the patient also presents as particularly manic in his or her thought expressions.
  3. 3. PSYCHOSIS  The disorganized thinking and loss of reality testing involved in psychosis may also make a patient emotionally unstable. For this reason, physicians also assess whether the patient seems or has seemed irritable, explosive, or suspicious of others. A physician evaluating psychosis is also likely to check for excessive introspection or withdrawn mood. Because patients with psychosis can no longer process thoughts and stimuli normally, they often regress to a level of self-focus more common in earlier stages of development. This may also lead to problems with impulse control and difficulty maintaining normal ego boundaries, both of which can be signs of a potential psychosis. Physicians evaluate each of these signs with a consideration of each experience's nature, duration, and recurrence. They will assess level of impairment and determine the patient's degree of insight into his or her experience. All of this information then helps in the development of a diagnosis and treatment plan.

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