Coming Soon! “Ethics and DSM V: Comprehensive Assessment of Perceptual Disturbance” 5 hours CEU educational course. This is a unique approach to training mental health professionals in diagnosing since it focuses on the common factor of perceptual disturbance in all mental disorders. Disturbance in perception is a cornerstone of diagnosing accurately. This continuing educational training also helps participants determine when to discuss the diagnosis with the patient and the hazards of ‘labeling’.
The Importance of Evaluating Perceptual Disturbance and Psychosis
Perceptual Disturbance is perhaps the most important clinical information to collect. In many ways it is the cornerstone of understanding mental disorders. Regardless of your psychotherapeutic approaches, the goal is change in your clients’ perception. This is true for everything from career struggles, developing self-esteem, addictions and severe mental illness. Knowing when to recommend evaluation for psychiatric medication is important. This requires an understanding of when psychosis is treatable with therapy or whether medication is required. Understanding altered perception and psychosis is fundamental to arriving at the correct diagnosis. If you have experience in the assessment of perceptual disturbance, you can diagnose many mental illnesses.
Perceptual Disturbance and Psychosis takes on many forms. Psychosis is observed in not only schizophrenia but schizoaffective, major depression, bipolar disorder, substance or drug induced, delirium, post-partum childbirth, dissociative disorders, head injury, medical disease and many others.
How do I assess non-psychotic perceptual disturbance?
Frequently, a psychosocial evaluation screens for psychotic symptoms but not a range of perceptual disturbance. Since every case is different, you will need to know when to inquire about non-psychotic perceptual problems. A great approach is to assess for perceptual anomalies and if these are significant, assess for psychotic symptoms. This is particularly true when you are in private practice or you work with populations with low rates of severe mental illness as it can facilitate your patient’s comfort with providing truthful and reliable information. Patients with histories of depressive episodes or suicidal thoughts or past attempts can be assessed using this approach.
For example, non-psychotic perceptual disturbance can also allow you to predict in advance a relapse of illness. Perhaps you have learned from experience with your patient that irrational fears, hypersensitivity to sound or other stimulation predicts the onset of a major depressive episode with severe psychosis. This also allows you to intervene proactively.
Modification of the Diagnosis
Unless your patient presents to you with a known diagnosis, you can usually only diagnose based upon current information available at the time of assessment. As you observe your patient over time and monitor symptoms this will render a clearer clinical picture. For this reason, you may later change your diagnosis of the patient. An important factor is whether the psychosis persists with treatment, whether there is partial remission or full remission. Full remission of psychosis occurs when it is substance induced. Full remission is possible with major depression. Full remission is usually not possible with schizophrenia. In this fashion, it is clear the importance of understanding psychosis in diagnosing mental disorders.
Diagnoses are often later modified for patients admitted to inpatient psychiatric treatment because the objective is to evaluate acute symptoms and proceed with admission.
This was an introduction to how developing a framework for understanding perception can be an aid in accurately diagnosing mental disorders. Please watch this site and sign up for the Ethics Demystified newsletter to receive announcements on workshop dates. eric-