The interview with the patient is the main time of the psychiatric examination, however, one can obtain information on the psyche of the subject by other means: It aims to reconstruct the personal history of the patient and of the diseaseThe main themes to look for are: It is to identify the main socio-demographic characteristics such as: name, age, sex, the address is to identify the main reason for which the patient consults, where he is encouraged to see a doctor according to, the specific terms of the complainant or of the accompanying c - Family History psychiatric: psychosis, neurosis, disorders of the humors, history of suicide Family medico-surgical Personal psychiatric: Medical-surgical: somatization disorder, associated treatments, surgery, concept of head trauma a prospective Gynecologic - obstetric and contraception Law: detentions earlier (times and reasons involved). Evolution of symptoms: rapid, slow, consultation and treatment received facial Expression: - We can note an aspect expressionless, dazed as in dementia, or mental confusion - A aspect inaccessible and distant in the schizophrenic - Aspect fixed of moral suffering in melancholy - Aspect seductive or erotic in it in some hysterical - Appearance of hypermimies: characterized by the intensity and vividness of the expression Aspect of hypomimie: characterized by the poverty of the expression is The behavior of sign: - Agitation: violent, anxious, unpredictable, incohercible, drama - Pulses gestures: spontaneous, abrupt, Unexplained - Stereotypies gesture, persévérations, mannerism sign Clinophilie: keeps the bed The mood is the level the emotional core of the subject: elan vital, emotionality, anxiety, intolerance to frustration - Affect of depression: sadness, pieur, despair, grief, disgust of ai life, loss of interest and pleasure, the existence of ideas of a project or a suicidal tendency - Affect expansive: happiness, euphoria, ecstasy - Dysphoria: discomfort, anxiety, anger - Negativism, indifference, dullness, emotional, abrasion, athymhormie - Reactivity of the hurrieur to the environment (harmony): lability, versatility, detachment, dramatization - Congruence and discordance as the mood Presence of delirium: seniority, themes, mechanisms, structure, membership, and subject's reaction face to this delusion æ Presence of false perceptions, illusions, hallucinose, hallucinations, feeling of already seen the Level of awareness vigil: clear consciousness, lucid clouding of consciousness, confusion, stupor. Orientation in time and space, Attention and concentration: ability to maintain attention, distractibility Ability to read, to write, calculate Ability Visio-spatiaüe: it is assessed by the ability to copy a geometric figure complex abstract Thinking: it is the ability to handle concepts and symbols (the patient must be able to find similarities and explain the proverbs). Culture and intelligence: it is assessed by the richness of the vocabulary used and the information contained in the speech, to be assessed according to the educational level, and socio-economic of the person concerned, the judgment is the ability to understand the relationships between facts and draw conclusions, in case of doubt, the explore by asking questions (what would you do if you feel a smell of smoke in the cinema.). -The insight is the ability of awareness and recognition of a psychological problem. Evaluation of your personality: It is done throughout the interview according to the criteria of the DSM, The psychiatrists are more dependent than other specialists of the data of the clinical examination, being given the absence in practice of specific indicators of the diagnosis. Further investigations are however necessary in order to affirm a etiology organic, and guide to the indications and the therapeutic follow-up. They are easy to use and can complement the clinical examination by a more comprehensive inventory of symptoms and by a quantitative assessment. Examples of scales: the scale of depression of Hamilton -The test of efficiency in intellectual that explore the intelligence and can help you determine the intellectual level of the subject -personality tests with questionnaires of personality such as the Minnesota Multiphasic Personnality Inventory (MMPI) and the test projective test like Rorschach. According to the guidance clinic Biological balance sheet standard - Balance sheet toxicoiogique Serology syphilis lumbar Puncture - fundus - Electro-encephalogram (EEG): the research of epilepsy or sign of suffering brain - CT scan brain: atrophy of the brain, hydrocéphalies, - occupying lesions intracranial, ventricular dilatation at the end of the examination, the information obtained is reported and held in a psychiatric observation that in addition to the data of the review will include a summary of the main information combination with syndromic symptoms and a discussion of the diagnosis, then followed by a decision diagnostic, therapeutic conduct and prognosis. The diagnostic classification will be done according to the DSM the five axes The evolution and prognosis depend on the etiology and therapeutic response - personal and family History (present or absent) - Personality pre-morbid (normal or pathological) - the Beginning of the disorder (acute or progressive), - Response to treatment (good or bad) Quality of social support (good or bad) psychological disorders: support for conduct disorders food: Evolution and prognosis of The personalities pathological: Diagnosis and conduct a tent in The differential diagnosis of schizophrénies anxiety disorders: differential Diagnosis.
