When is it Time for Evaluation and Treatment
When Is It Time For Evaluation and Treatment?
Symptoms, Symptom Clusters, Biologically Based Diagnosis, GAF & Medication Treatment
1. A person presents with a symptom or problem, such as concentration problems, or for some else it is anger management issues and this may be the main problem they are having and they want addressed with further evaluation and treatment.Conversations, with Dr. P Organizing Problems in Mental Health Part 1. Q and A
2. This complaint doesn’t occur in isolation but in combination with other problems or symptoms that the person has that they don’t realize may be related to their main problem. For example they can’t concentrate, and have been worrying too much, and have sleep problems, with this being a symptom cluster.Diagnostic Symptom Clusters or Groups
3. The symptom cluster may represent parts of a diagnosis, or a full diagnosis. Initial Screen with Example Diagnosis and Medication Responsiveness The problems above of concentration, sleep, and worry may represent a diagnosis of an Anxiety Disorder.
4. If the symptoms, their clusters, and diagnosis has a biochemical based brain cause it is biologically based and may a specific medications that may treat that biochemical basis. In the case above there are specific medications for Anxiety Disorders.
5. When the symptoms and symptom clusters are severe enough to cause significant distress and/or impairment then they require evaluation.
6. The severity and functioning can be estimated by using the Global Assessment of Functioning Scale or GAF, which has two components the[A.] distress or symptom severity and[B.] functioning. GAF Global Assesment of Functioning Scale It scores from zero to 100, 100 meaning superior functioning with no symptoms or distress, 50 meaning moderately serious symptoms and distress, e.g. suicide ideas, and impairment in functioning, failing at school, to say 25 meaning very serious symptoms like suicide preoccupation, or serious impairment like staying in bed all day.
7. The GAF is introduced not to be literally used but to give one a sense of using an objective estimate based on distress and impairment used to pick treatments and to quantify their impact on these two measures, much as one would use numbers to measure blood pressure.
8. Using the example above if the person had so much anxiety, and poor concentration, and such poor sleep, that they could not do their job, or were failing school, the distress and level of functioning would be considered very serious and severe, say scoring it at 50, and after treatment of this biologically based disorder with medication, they could go back to school or work and do pretty well with no or only mild worry, good concentration, and only mild insomnia, they might be scored 75.
9. Mental health diagnosis are made clinically using [A.] symptom presentation ,[B.] personal and family history, and[C.] individual and family treatment response, using the data gathered as an integrated whole. How a Psychiatric Medical Doctor starts to make a Diagnosis Q and A, Initial Diagnostic Mental Health History and Checklist
10. Additionally a biological diagnosis is made based on symptoms due to multiple biochemical causes requiring different medications even within the same class for adequate treatment, being based on mechanisms of action and specific treatment responses.PsychoPharm 101 Importance of the Biochemical Diagnosis and intro to the most useful medications
11. The responses to medications are not only therapeutic, but the good effects and negative effects help confirm and clarify the biochemical diagnosis and determine the next steps in adjusting, discontinuing or adding a new medication. This will be discussed in detail as we discuss specific diagnoses and their medication treatments.
12. In summary when symptoms of a biologically based mental health diagnosis, reach a severity that they cause significant distress and/or impairment at home, school, work and socially, then medications based on the underlying biochemical imbalances are needed. These medications may be a essential for adequate treatment, which includes not only symptom relief, but also prevention of relapses and complications. The efficacy can be measured by using a tool like the GAF scale before and after treatment.