Description A psychiatric diagn...
Description
A psychiatric diagnosis having characteristics of schizophrenia and affective disorder (depression). Patients experience psychosis, such as hallucinations or delusions, and symptoms of elevated or depressed mood. Untreated, patients become disenfranchised and are unable to hold jobs or perform their normal daily responsibilities.
Symptoms
Symptoms vary widely but include: very good or bad mood, abnormal thoughts, changes in appetite and energy, belief that someone on TV or radio is speaking directly to them, believe secret messages are hidden in common objects, disorganized speech that is not logical, false beliefs (delusions), feeling that everyone or one person or agency is out to get them (paranoia), irritability, poor temper control, lack of concern with hygiene, sleeping problems, seeing or hearing things (hallucinations), trouble concentrating.
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. Tests may be done to rule out other causes of the symptoms such as thyroid disease, electrolyte problems, drug abuse, and adverse drug interactions.
Tests:
Comprehensive metabolic panel (CMP)
Other Specific Tests: Thyroid studies, urine and/or serum toxicology screen
Do I need this test?
Don't prescribe antipsychotic medications to patients for any indication without appropriate initial evaluation and appropriate ongoing monitoring. Metabolic, neuromuscular and cardiovascular side effects are common in patients receiving antipsychotic medications for any indication, so thorough initial evaluation to ensure that their use is clinically warranted, and ongoing monitoring to ensure that side effects are identified, are essential. "Appropriate initial evaluation" includes the following: (a) thorough assessment of possible underlying causes of target symptoms including general medical, psychiatric, environmental or psychosocial problems; (b) consideration of general medical conditions; and (c) assessment of family history of general medical conditions, especially of metabolic and cardiovascular disorders. "Appropriate ongoing monitoring" includes re-evaluation and documentation of dose, efficacy and adverse effects; and targeted assessment, including assessment of movement disorder or neurological symptoms; weight, waist circumference and/or BMI; blood pressure; heart rate; blood glucose level; and lipid profile at periodic intervals.
Specialists:
Psychiatry, Pediatric and Adolescent Psychiatry
Workup:
A history and physical exam will be performed. Tests may be done to rule out other causes of the symptoms such as thyroid disease, electrolyte problems, drug abuse, and adverse drug interactions.
Tests:
Comprehensive metabolic panel (CMP)
Other Specific Tests: Thyroid studies, urine and/or serum toxicology screen
Do I need this test?
Don't prescribe antipsychotic medications to patients for any indication without appropriate initial evaluation and appropriate ongoing monitoring. Metabolic, neuromuscular and cardiovascular side effects are common in patients receiving antipsychotic medications for any indication, so thorough initial evaluation to ensure that their use is clinically warranted, and ongoing monitoring to ensure that side effects are identified, are essential. "Appropriate initial evaluation" includes the following: (a) thorough assessment of possible underlying causes of target symptoms including general medical, psychiatric, environmental or psychosocial problems; (b) consideration of general medical conditions; and (c) assessment of family history of general medical conditions, especially of metabolic and cardiovascular disorders. "Appropriate ongoing monitoring" includes re-evaluation and documentation of dose, efficacy and adverse effects; and targeted assessment, including assessment of movement disorder or neurological symptoms; weight, waist circumference and/or BMI; blood pressure; heart rate; blood glucose level; and lipid profile at periodic intervals.
Specialists:
Psychiatry, Pediatric and Adolescent Psychiatry
Treatment
Therapy can vary depending on the severity of symptoms. The primary treatments are psychotherapy and medications. Medications used include: antipsychotics to treat psychosis, medications for mood stabilization, and anti-depressants.