{"id":765,"date":"2021-12-08T06:45:00","date_gmt":"2021-12-08T06:45:00","guid":{"rendered":"https:\/\/stop-depression-info.com\/blog\/?p=765"},"modified":"2022-01-06T06:45:42","modified_gmt":"2022-01-06T06:45:42","slug":"methods-for-the-diagnosis-of-mental-illness","status":"publish","type":"post","link":"https:\/\/stop-depression-info.com\/blog\/methods-for-the-diagnosis-of-mental-illness\/","title":{"rendered":"Methods for the diagnosis of mental illness"},"content":{"rendered":"\n<p>An overview of all methods of diagnosing functional mental illnesses (schizophrenia, depression, and&nbsp;others) from&nbsp;Doctor of Medical Sciences Irina Valentinovna Shcherbakova.&nbsp;&nbsp;<\/p>\n\n\n\n<p>The most important stage in psychiatric care for patients&nbsp;is the establishment of the correct diagnosis.&nbsp;It is the diagnosis that determines the further strategies of patient management, treatment, prognosis and&nbsp;prospects.&nbsp;&nbsp;<\/p>\n\n\n\n<p>By the&nbsp;methods of diagnosis in&nbsp;psychiatry include:&nbsp;&nbsp;<\/p>\n\n\n\n<ul><li>clinical&nbsp;&#8211; conversation, observation&nbsp;<\/li><li>psychometric&nbsp;&#8211; pathopsychological research&nbsp;<\/li><li>laboratory&nbsp;&#8211; genetic, immunological (Neurotest)&nbsp;<\/li><li>instrumental&nbsp;&#8211; tomography, EEG, Neurophysiological test system (NTS)&nbsp;<\/li><\/ul>\n\n\n\n<p><strong>Clinical methods<\/strong><\/p>\n\n\n\n<p>The main methods of diagnosing mental illness remain clinical.&nbsp;To determine a mental disorder, the doctor uses information about the&nbsp;symptoms of the disease, which he receives from the&nbsp;patient and&nbsp;his loved ones during&nbsp;the conversation.&nbsp;In addition, the doctor observes the&nbsp;patient:&nbsp;his motor activity, facial expressions, emotions, speech, and the nature of his thinking.&nbsp;Assessment of the development and&nbsp;modifications of the signs of the disease gives an idea of \u200b\u200bthe&nbsp;speed of the course of the disease, its nature.&nbsp;An analysis of the totality of the obtained clinical data makes it possible to establish a specific mental disorder.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Clinical methods&nbsp;<\/strong>depend on&nbsp;subjective factors:&nbsp;&nbsp;<\/p>\n\n\n\n<ul><li>the frankness of patients, their&nbsp;relatives in the&nbsp;presentation of the picture of the disease and the&nbsp;facts of the biography&nbsp;&nbsp;&nbsp;<\/li><li>experience and&nbsp;knowledge of the doctor&nbsp;<\/li><\/ul>\n\n\n\n<p>The use of additional objective research methods&nbsp;&#8211; laboratory, instrumental&nbsp;&#8211; increases the reliability of the diagnosis of mental disorders and&nbsp;allows you to choose the optimal means of therapy.&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>Most public and&nbsp;private psychiatric clinics are limited only to &#8220;necessary and&nbsp;sufficient&#8221; clinical examination methods.&nbsp;First of all, we are talking about the&nbsp;diagnosis of functional mental disorders&nbsp;&#8211; those that occur in the absence of brain damage.&nbsp;In functional disorders, X-rays or tomography do not&nbsp;show any abnormalities.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>By&nbsp;common functional disorders include:&nbsp;<\/p>\n\n\n\n<ul><li>endogenous psychoses, including schizophrenia, schizoaffective and&nbsp;delusional disorders&nbsp;<\/li><li>schizotypal disorder<\/li><li>mood disorders (depression, mania, bipolar disorder)<\/li><li>neurotic disorders<\/li><\/ul>\n\n\n\n<p>The symptoms of these diseases can be very similar to each other or &#8220;overlap&#8221;, acting as non-specific signs of mental pathology.&nbsp;This often occurs in the&nbsp;early stages of development or temporary attenuation of painful conditions.&nbsp;<\/p>\n\n\n\n<p>The distinction between an outwardly similar, but&nbsp;for&nbsp;essentially different diseases&nbsp;&#8211; a difficult task, which may take several months (!).&nbsp;To recognize a mentally ill person, it is necessary to use different diagnostic methods in&nbsp;combination (clinical, psychometric, laboratory and&nbsp;instrumental).&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>It is also important to make a correct diagnosis early&nbsp;because, thanks to an early start of treatment, the patient goes into&nbsp;remission or recovers&nbsp;faster&nbsp;, and his quality of life and&nbsp;social prognosis&nbsp;improve&nbsp;.&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Psychometric diagnostic methods in&nbsp;<\/strong><strong>psychiatry<\/strong><strong>&nbsp;<\/strong><strong><\/strong><\/p>\n\n\n\n<p><strong>Psychometric methods&nbsp;<\/strong>provide more information about&nbsp;the patient&nbsp;&#8216;s&nbsp;current mental health status&nbsp;.&nbsp;The specialist uses standardized scales (which have passed scientific research) to assess mental disorders in&nbsp;points: anxiety, depression, mania, dementia.&nbsp;Psychometry provides the doctor with additional information about the&nbsp;severity of the disorder, as&nbsp;well as the&nbsp;effectiveness of treatment.&nbsp;&nbsp;<strong><\/strong>&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>Psychometric scales are divided&nbsp;into:&nbsp;<\/p>\n\n\n\n<ul><li>self&nbsp;&#8211;&nbsp;questionnaires&nbsp;&#8211; the patient fills in&nbsp;based on his feelings&nbsp;&nbsp;<\/li><li>questionnaires&nbsp;&#8211; filled in by the doctor&nbsp;<\/li><\/ul>\n\n\n\n<p>More expanded and&nbsp;concretizing information is provided by&nbsp;<strong>pathopsychological examination&nbsp;<\/strong>.&nbsp;It is conducted by a clinical psychologist.&nbsp;&nbsp;<strong><\/strong><\/p>\n\n\n\n<p>To understand that a&nbsp;person has a mental disorder,&nbsp;a battery of standardized tests, tasks and&nbsp;scales is&nbsp;used as psychodiagnostic methods&nbsp;.&nbsp;They assess the main areas of the psyche:&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<ul><li>thinking<\/li><li>Attention<\/li><li>emotions<\/li><li>will<\/li><li>memory<\/li><li>intelligence<\/li><li>personality traits of a person<\/li><\/ul>\n\n\n\n<p>During the examination, the specialist finds even the smallest changes that have not yet been&nbsp;determined by clinical methods.&nbsp;The method is most effective when a&nbsp;mental disorder is&nbsp;suspected&nbsp;, to clarify the diagnosis, to assess the degree of mental defect.&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Laboratory methods<\/strong><\/p>\n\n\n\n<p>Improving the efficiency of diagnostics is directly related to the&nbsp;development of new methods and&nbsp;principles for diagnosing mental disorders, which are based on&nbsp;objective biological criteria.&nbsp;The&nbsp;now actively being sought biological signs (markers) for schizophrenia and&nbsp;schizophrenia spectrum disorders: examines genetic, immunological, neuro-physiological parameters.&nbsp;Finding the features that are inherent in a particular disease&nbsp;is the basis for creating additional diagnostic tests for&nbsp;schizophrenia.&nbsp;Despite&nbsp;worldwide efforts, there are very few such features openly.&nbsp;Below we will&nbsp;consider the most significant of&nbsp;them.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Genetic factors&nbsp;<\/strong>make an&nbsp;undeniable contribution to the&nbsp;formation of a predisposition to&nbsp;schizophrenia and&nbsp;other mental illnesses&nbsp;.&nbsp;Indeed,&nbsp;patients&#8217; families often have relatives who suffer from mental disorders.&nbsp;The closer the degree of consanguinity&nbsp;, the higher the risk of getting sick.&nbsp;The risk is highest if both parents or the patient&#8217;s twin are ill.&nbsp;&nbsp;&nbsp;&nbsp;<strong><\/strong>&nbsp;&nbsp;<\/p>\n\n\n\n<p>Attempts to find genes&nbsp;&#8211; markers of schizophrenia have led to&nbsp;ambiguous conclusions.&nbsp;It turned out that&nbsp;patients with&nbsp;schizophrenia have hundreds of gene abnormalities in&nbsp;various combinations.&nbsp;The identification of such deviations is not&nbsp;evidence of schizophrenia, but&nbsp;only indicates the&nbsp;likelihood of its&nbsp;occurrence.&nbsp;The development of the disease occurs when many factors (internal and&nbsp;external)&nbsp;interact&nbsp;, including genetic ones.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>Another direction in the&nbsp;search for markers of schizophrenia and&nbsp;schizophrenia-like disorders&nbsp;is&nbsp;<strong>immunological methods&nbsp;<\/strong>.&nbsp;By the&nbsp;end of the twentieth century, a close connection between the nervous and&nbsp;immune systems&nbsp;became apparent&nbsp;, special molecules and&nbsp;substances were&nbsp;discovered&nbsp;that are involved in&nbsp;this interaction.&nbsp;&nbsp;&nbsp;&nbsp;<strong><\/strong>&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>It turned out that some of the immune factors that circulate in the&nbsp;blood can respond to&nbsp;mental changes and&nbsp;reflect the disease processes that occur in&nbsp;the brain.&nbsp;Among such factors:&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<ul><li>antibodies to&nbsp;brain proteins&nbsp;<\/li><li>leukocyte elastase<\/li><li>alpha 1-proteinase inhibitor<\/li><li>C-reactive protein<\/li><\/ul>\n\n\n\n<p>The number of antibodies to&nbsp;brain proteins increases markedly in some forms of schizophrenia, autism, and developmental delays.&nbsp;The measurement of the level of such antibodies in the&nbsp;blood is widely used as a method to complement clinical methods of psychiatric diagnosis.&nbsp;In&nbsp;isolation from&nbsp;clinical data, this method is not&nbsp;valid, since an increase in the level of antibodies is also observed&nbsp;in other diseases of the nervous system: multiple sclerosis, encephalitis, trauma, and tumors.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>A more sensitive way to diagnose mental disorders&nbsp;is to determine in the&nbsp;blood indicators of innate immunity,&nbsp;namely, pro-inflammatory factors: leukocyte elastase, alpha-1-proteinase inhibitor, C-reactive protein.&nbsp;Scientific studies have found a connection between these indicators with the&nbsp;exacerbation of schizophrenia, the nature of the course and&nbsp;its&nbsp;form, as&nbsp;well as the degree of mental defect.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>By&nbsp;combining&nbsp;the measurement of pro-inflammatory markers with the&nbsp;level of antibodies to&nbsp;brain proteins in the&nbsp;blood (protein S-100, myelin basic protein), a new tool for objectifying the diagnosis&nbsp;,&nbsp;<strong>Neurotest&nbsp;<\/strong>,&nbsp;was created&nbsp;, which increases the reliability of the detection and&nbsp;prognosis of schizophrenia and&nbsp;schizophrenia-like disorders.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<strong><\/strong>&nbsp;&nbsp;<\/p>\n\n\n\n<p><strong>Instrumental methods<\/strong><\/p>\n\n\n\n<p>Instrumental examination methods&nbsp;&#8211; tomography, electroencephalography (EEG) &#8211;&nbsp;help to&nbsp;determine mental abnormalities in a&nbsp;person&nbsp;.&nbsp;With functional mental illness, they are used in a limited way, according to&nbsp;indications.&nbsp;The data from these examinations are useful for differential diagnosis.&nbsp;For example, magnetic resonance imaging is required when you need to make sure that mental symptoms are not&nbsp;associated with&nbsp;damage to brain tissue, blood vessels, or neuroinfection.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>Traditional&nbsp;<strong>studies of brain bioelectrical activity (EEG)&nbsp;<\/strong>in endogenous diseases such as schizophrenia&nbsp;show no specific abnormalities.&nbsp;More interesting results are obtained by an EEG recorded under&nbsp;conditions of exposure of the&nbsp;patient to sound, visual and&nbsp;other stimuli.&nbsp;Under&nbsp;these conditions, the&nbsp;so-called evoked potentials are recorded&nbsp;in the&nbsp;patient.&nbsp;<strong><\/strong>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>In&nbsp;patients with&nbsp;schizophrenia, schizotypal disorder and&nbsp;predisposed persons, the parameters of some evoked potentials (components P50, P300, N400, NA) may differ significantly from&nbsp;healthy ones.&nbsp;These anomalies reflect the difficulty in recognizing signals, impaired memory and&nbsp;directed attention, and impaired cognitive functions in&nbsp;general.&nbsp;Some anomalies are associated with the&nbsp;severity, duration of the disease, its&nbsp;syndromes.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>Although special evoked potentials can occur in depression, strokes, brain trauma, alcoholism,&nbsp;their&nbsp;assessment, together with&nbsp;clinical data, helps the doctor in&nbsp;diagnosing schizophrenia and&nbsp;schizophrenia-like disorders.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>A more specific study for schizophrenia&nbsp;is the&nbsp;<strong>antisaccades&nbsp;<\/strong><strong>test&nbsp;<\/strong>, which detects lack of smooth eye movement.&nbsp;This symptom occurs in almost&nbsp;80% of people with&nbsp;schizophrenia and&nbsp;indicates a&nbsp;functional deficiency of the frontal cortex (&#8220;hypofrontality&#8221;).&nbsp;Since a similar defect is often demonstrated by healthy relatives of patients (genetic trait), a higher diagnostic sensitivity is achieved with a comprehensive electroencephalographic examination.&nbsp;&nbsp;<strong><\/strong><strong>&nbsp;<\/strong><strong><\/strong>&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n\n\n\n<p>Such a complex contains a test for&nbsp;antisaccades and&nbsp;tests with the&nbsp;determination of evoked potentials (P50 or P300).&nbsp;It is also advisable to measure the prestimulus inhibition of the startle reflex (SR), which reflects a person&#8217;s innate response (startle) to a&nbsp;sudden loud sound.&nbsp;Deviations of the startle reaction are observed in schizophrenia, already in the&nbsp;early stages of the disease.&nbsp;This diagnostic battery of EEG tests is called the&nbsp;<strong>Neurophysiological Test System&nbsp;<\/strong>.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<strong><\/strong><\/p>\n\n\n\n<p>The methods described above for diagnosing mental illness are used in&nbsp;addition to&nbsp;clinical ones.&nbsp;They are based on the&nbsp;results of world research, represent different ways of recording biological changes that are characteristic of mental illness.&nbsp;The principle is the&nbsp;same as&nbsp;in&nbsp;other areas of medicine: after examination and&nbsp;conversation, the doctor prescribes clarifying examinations with&nbsp;various options&nbsp;&#8211; ultrasound, X-ray, analyzes.&nbsp;The aggregate of the obtained&nbsp;health&nbsp;data&nbsp;increases the accuracy of the diagnosis and&nbsp;minimizes errors&nbsp;.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>An overview of all methods of diagnosing functional mental illnesses (schizophrenia, depression, and&nbsp;others) from&nbsp;Doctor of Medical Sciences Irina Valentinovna Shcherbakova.&nbsp;&nbsp; The most important stage in psychiatric care for patients&nbsp;is the establishment of the correct diagnosis.&nbsp;It is the diagnosis that determines the further strategies of patient management, treatment, prognosis and&nbsp;prospects.&nbsp;&nbsp; By<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[1],"tags":[],"_links":{"self":[{"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/posts\/765"}],"collection":[{"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/comments?post=765"}],"version-history":[{"count":1,"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/posts\/765\/revisions"}],"predecessor-version":[{"id":766,"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/posts\/765\/revisions\/766"}],"wp:attachment":[{"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/media?parent=765"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/categories?post=765"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stop-depression-info.com\/blog\/wp-json\/wp\/v2\/tags?post=765"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}