Online consultation in the psychiatric departmentThe following is some information about online psychiatric consultation:
** I. Platform and service content for online consultation **
Some platforms (such as Meituan Medicine) had already launched online consultation services for mental and psychological departments, which could provide online consultation services for patients (including autistic patients and their families) from famous doctors in tertiary Grade A hospitals. They also set up sections such as children's consultation, psychiatric consultation, and popular science section. Through these platforms, it was easy to communicate with professional psychiatric doctors.
** 2. Psychiatrist consultation process and key points **
1. ** Ask about medical history **
- ** Syndrome related **: The doctor will pay attention to the time when the symptoms appear, including when the symptoms begin to appear, the specific psychological and physical symptoms, the time when these symptoms appear, the duration, and the severity. For example, if a patient showed symptoms related to emotions, the doctor needed to know when the symptoms such as depression or abnormal excitement began and how long they lasted every day.
- "Pathological Exploration": The patient will be asked if they have experienced any recent traumatic events, such as marriage changes, the death of a loved one, etc. They will also be asked if there are any traumas in childhood, such as emotional neglect, emotional abuse, etc. These experiences had an important impact on the patient's personality and coping style, and also helped to understand the cause of the disease.
- ** Prior Treatment **: Find out if the patient has had similar symptoms or other mental illnesses before. For example, if there is a history of manic episodes and a history of depression, it may be a case of depression in a person with a disorder. At the same time, the doctor would ask about the previous treatment methods, the drugs used (including whether diet therapy, tobacco, alcohol, etc. were used to try to improve the symptoms, because these may affect the symptoms of depression), and the recovery after treatment.
- ** Family History **: Pay attention to whether the patient's grandparents, maternal grandparents, parents 'siblings, and own siblings have a history of mental illness. However, it was important to note that although mental illnesses had a certain degree of inheritance, having a patient in the family did not mean that the patient would definitely get sick, because mental illnesses were affected by many factors such as biological, psychological, and social factors.
2. ** Mental Examination **
- ** Emotional state **: Many patients with mental illnesses have emotional problems. For example, most patients with depression are depressed and feel that everything is terrible and hopeless. However, there are also patients with "smiling depression" who seem to smile normally most of the time, but the suicide rate of these patients is very high. Some patients may have extreme emotional fluctuations, such as sometimes low mood and sometimes high mood.
- ** Status of interests **: Most patients will show signs of a decrease in interest. Even if they liked things in the past, they will not be able to enjoy them now.
- ** Energy and sleep **: The patient may feel powerless and tired easily. In terms of sleep, symptoms such as light sleep, easy waking up, difficulty falling asleep, or drowsiness may occur.
- [** Thought state **: There may be a delay in thinking, which is manifested as speaking less, speaking slower, and so on.]
- ** Suicidal tendencies **: The doctor needs to know whether the patient has suicidal thoughts, attempted suicide, or has already attempted suicide.
- ** Physical discomfort symptoms **: Some patients will have headaches, low back pain, stomach pain, short breath, chest tightness, nausea, and other discomfort symptoms. These symptoms may sometimes be the main manifestations of mental illnesses such as depression, which can easily lead to misdiagnosis. The patient may repeatedly seek medical treatment because of these symptoms, but the actual disease of the body organs cannot be found.
3. ** Physical examination **
- In order to confirm the mental illness and eliminate the interference of physical diseases (such as Alzheimer's disease, tumor, thyreoid disease, etc.), the suspected patient would be examined by general examination, nervous system examination, and auxiliary examination (such as blood routine, urine routine, B-ultrasound, infectious disease screening, etc.). This was because some drugs (such as chemotherapy drugs, drugs that inhibited organ transplant rejection, etc.) could induce depression. If it was physical illness and drug-related depression, it would be different from a simple mental illness diagnosis.
4. ** Assessment **
- ** Disease diagnosis and assessment **: The doctor will evaluate the patient according to the results of the above series of examinations and different diagnosis systems (such as the authoritative diagnosis standards such as DSS5 and ICD10). The DSM - 5 was the fifth edition of the diagnosis and statistics manual of mental disorders developed by the American Psychiatrist Association. It was a commonly used guidance manual in the field of mental disorders.
- ** Assessment of severity **: There are other assessments (such as the Hamilton depression scale) and self-assessments (such as the Self-Rating depression Scale (SSS), the 9-Item Patient Health Q- 9, etc.) to assess the severity of mental illness.
** 3. Common conditions that require psychiatric consultation **
1. ** Thinking **: Confusion of thoughts, such as being sensitive and suspicious (suspecting others of stealing, poisoning, etc.), muttering to themselves, giggling, often throwing tantrums, etc.
2. ** Emotional aspects **: Emotional instability, such as sometimes being in a bad mood, not wanting to do anything, feeling that life is boring, sometimes talking non-stop, full of energy, spending money recklessly, etc., may have the possibility of manic depression.
3. ** Sudden change in personality and mood **: An introverted person suddenly becomes extroverted and takes the initiative to interact with others. It may be a two-way performance.
4. ** Physical discomfort but unable to find the cause **: Always feeling unwell, repeatedly going to the hospital for checkups but unable to find any problems, various treatments are not effective, this is the so-called "visiting doctor syndrome". This situation may be a mental and psychological problem rather than a physical illness.
5. ** Weird behavior **: Do something that doesn't fit the situation, such as being happy when others are sad.
6. ** Sleep and appetite problems **: Sleep problems (insomnia, dreams, early waking, etc.), poor appetite, lack of appetite, weight loss, etc. If you can't find the physical reason, you need to consider mental and psychological problems.
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