정신과적 평가 신 정 호 연세 원주의대 정신과학교실.

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Presentation transcript:

정신과적 평가 신 정 호 연세 원주의대 정신과학교실

면담 정신과적 면담 면담 기술 Rapport as early as possible Chief complaints Tentative differential diagnosis R/O diagnosis, impression Clarify obscure answers

면담 면담기술(계속) Let pt talk freely for at least 3,4m Open and closed question Don’t be afraid to ask sensitive material Ask about suicide idea Afford pt to ask before termination Trust and hope

면담의 관리 시간 Initial interview: 30 – 60m 진찰실 및 좌석 배치 기록 특수 상황 Suicidal patient Violent patient Delusional patient Interview with family

Psychiatric History Taking Identification of patient Main problems Present illness Past history Family history

Psychiatric History Taking Personal history Prenatal and perinatal period Early childhood ( – 3 y) Middle childhood(3 – 11 y) Late childhood(from puberty to adolescent) Adulthood Psychosexual history Dream, fantasy, value

Mental Status Examination General appearance, attitude and behavior Emotional reaction Stream of thought Contents of thought Sensorium, mental grasp and capacity

Medical Evaluation Basic screening test Neuroendocrine test TRH stimulation test, DST Neuroimaging study Brain CT, MRI, SPECT, PET Neurophysiologic study EEG, Polysomnography, Evoked potential

Psychological Test Intelligence test Personality test Symptom checklist Psychological test for perceptual and memory ability Neuropsychological test Self report test Projective test

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